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Student Broadband Package Application Form

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Student Broadband Package Application Form

Student Information

Name Mr M Qumar Iqbal Rana

Registration # PMAF10E017

Mobile # 03007679907

Home Phone # 483794063

Email Address mr.rajputt@hotmail.com

Customer Type Student

NIC # 38403-4233370-7

Package Information

Broadband Phone # 483794063

City Sargodha

Package 1 MB

University Information

University Name University Of Sargodha

Department Mathematics

University City Sargodha

University Contact Number 489230767

Date Of Enrolment 06-SEP-2010

Date of Completion 31-DEC-2012

University Verification

Name of Registrar/Dean/Principal/faculty .............................................

Signature & Stamp .............................................

Signature of Student .............................................

For PTCL Use only

Login Choice 1 03007679907

Login Choice 2 ...............................

Login Choice 3 ...............................

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